From CNN.com Today/Eissenberg study with feedback

[ckc]

Hifi, it does make me wonder how the MHRA is going to say that the E-Cigs is classed as 'medical' when it has no affect on metabolism.

 

[slybootz]

To take my hand saw/chain saw analogy on a stage here, what the study appears to have tested is how an experienced hand saw user would fare with a chain saw having had no training in its use and not even knowing that you have to start the engine to make it work. And perhaps even having put diesel in the fuel tank instead of petrol (because the diesel was in a can labelled "Petrol").

While I fully accept that the results you have obtained are valid for your methodology, and to pick up on your coin toss analogy, after the 16th toss I'd be checking the coin for weight bias - while 16 straight heads is not impossible, it's improbable, and experience tells me that the same applies here.

Reiterated for great analogy.

I found a thread from a new user to Crown7's Hydro E-cig. He contacted Crown7 about proper use of their products, and they recommended dripping directly on the atomizer.

When you drip a single drop onto the mesh metal of the atomizer, put the cart back on and let it soak in for a minute. When you inhale this will produce a lot of potent vapor even off of one drop. You’ll be pushing it with 2 drops. I was leery about doing this at first because I didn’t want to unintentionally damage the atomizer. I contacted crown 7 support and responded quickly giving me advice on how to do it. Crown 7 support recommended one on the atomizer.

It seems like even the manufacturer of this specific model recommends direct dripping, so I don't think this is too far-fetched of a technique to be tested..

 

[watfordjc]

Assuming the study data suggests that electronic cigarettes are less effective at nicotine delivery than cigarettes, that wouldn't be much of an issue to me.

100% of the nicotine in an unlit cigarette doesn't reach a smokers blood stream, so it would be wrong to assume 100% of the nicotine in unvapourised e-liquid would reach a vapers blood stream.

If someone had to spend 20 times as long vaping as they did smoking - purely to get their blood-nicotine concentration to their desired level - is that not less harmful than smoking?

If I had to choose between 200 puffs from cigarettes and 4000 puffs from an e-cig, I wouldn't buy 20 B+H just because it would save me time inhaling (ignoring the time I'd spend having to go outside). Not to mention the irritability and cravings when in the situations of not being able to smoke.

Take a bunch of smokers, measure how much time in seconds they spend smoking in a week, and measure their blood-nicotine level at regular intervals.

Train those smokers how to use an electronic cigarette effectively, and then spend another week measuring the time in seconds they spend vaping a certain strength liquid, also measuring their blood-nicotine level at regular intervals.

Chances are, blood-nicotine levels will be consistent for both, and the only difference would be the amount of time spent inhaling smoke/vapour. Nicotine concentration in a vapers blood might even be lower if some of those smokers had a cigarette (for a fixed length of time) as something to do instead of for nicotine.


John.

 

[(So) Jersey Girl]

If this study holds true, then I really have to classify my e-cig (crappy as it is) as a miracle device. I have smoked since age 15, have tried every "approved" method to quit (all eventually unsuccessful) and have, in the last 3 weeks, gone from smoking a pack a day for 30+ years to 0. I don't think the FDA has the authority to approve or regulate miracles!

 

[Raven1]

I saw that report on our local news. This is a bunch of BS (where do they get this stuff from, unless it's just another bogus campaign to rid the world of e-cigs?). I think I get MORE nicotine from e-liquid than analogues and I don't believe it's placebo effect as when I've tried higher nic juices they've been too much for me.

 

[Koman]

Hmm, I usually trusted CNN. Do you think major tobacco companies have an influence here?

 

[DVap]

Test just performed:

I made a solution of 10 mL distilled water + 5 drops bromothymol blue indicator:
Result: yellow (non basic) solution.

I have just opened an unused 510 atomizer (containing a small quantity of priming fluid), placed atomizer into solution, and agitated 60 seconds:
Result: yellow (non basic) solution.

Added 10 uL of 15 mg/mL nicotine (containing 150 micrograms nicotine) in PG/VG to previous solution:
Result: Immediate color change to deep blue.

Conclusion:

Bromothymol blue indicator, which is extremely sensitive to pH change, does not respond to the atomizer fluid used in this test, therefore the priming fluid does not contain nicotine.

---

This simple test, of course, can be repeated with other atomizer models, including those used in Dr E's study.

If the priming fluid in the NJoy and Crown 7 atomizers is similarly non-nicotine bearing, and if Dr. E's staff did not purge the priming fluid before giving the ecigarettes to the subjects, Dr. E's study has successfully demonstrated that priming fluid does not contain nicotine (with the realization that a slow mixing of priming fluid and cartridge liquid will begin to occur once the cartridge is attached to the atomizer).

Dr. E, you need to investigate this possibility, as it represents a potentially fatal flaw in your study. If the atomizer priming fluid was not characterized/accounted for, you've got a big problem on your hands.

If you find that your staff, on the other hand, blew out or washed out the priming fluid such that the vapor producing liquid was the nicotine containing cartridge liquid, not the priming liquid, then fatal flaw averted.

 

[DeeEss]

Hmm, I usually trusted CNN. Do you think major tobacco companies have an influence here?

I'd like to believe that's not the case (Occam's razor and such). Dr. Eissenberg has said in this thread (I think) that he was misquoted. So, it's probably just poor journalism at best, considering that the FDA is still claiming that they're legally capable of stopping any and all shipments. And I just now noticed that in the original article, there was the following paragraph:

"A judge has yet to rule on the company's request for an injunction that would allow imports to resume. "There has been no change," said FDA spokesman Siobhan DeLancey. She said "a decision in the case is still pending, with no timeline."

This has been changed to:

"A judge January 14 ruled the FDA does not have such authority, but the agency has taken the matter to the U.S. Court of Appeals, which has yet to decide the case. The appeals panel issued a stay against the judge's ruling until it can rule on the agency's appeal."

I did contact them with a link showing that there had been a ruling against the FDA's blockage of shipments, although I don't know if it was my actions that were responsible for that.

 

[curiousJan]

Dr. Eissenberg has said in this thread (I think) that he was misquoted.

Actually he's defended his statement as quoted ... ECF members have attempted to make the point that the statement is too general and should have specifically referenced only the 2 pv models/companies that were used in the study.

That said, he has been very gracious in coming and participating in the discussion, and while I might disagree with the quoted statements and have questions regarding the methodology of the study, I appreciate his input, support his desire to perform further testing, and thank him for his time and efforts!

Jan

 

[rothenbj]

To take my hand saw/chain saw analogy on a stage here, what the study appears to have tested is how an experienced hand saw user would fare with a chain saw having had no training in its use and not even knowing that you have to start the engine to make it work. And perhaps even having put diesel in the fuel tank instead of petrol (because the diesel was in a can labelled "Petrol").

While I fully accept that the results you have obtained are valid for your methodology, and to pick up on your coin toss analogy, after the 16th toss I'd be checking the coin for weight bias - while 16 straight heads is not impossible, it's improbable, and experience tells me that the same applies here.

OT here for a lot of reasons. First I'd like to mention that I really liked your youtube video. Second, assuming there is no weight bias to the coin, the chances of the 17th coin flip coming up heads after the last 16 were heads is exactly 50%.

Finally, I believe the NFC won the last dozen or so coin flips in the Super Bowl, but next year they have a fifty percent chance of doing it again.

 

[TropicalBob]

Very helpful, Dvap, as usual. Good work.

We are still left with the conclusion that 16mg liquid in factory-sealed carts does not deliver sufficient nicotine. Dr. Laugesen was good enough to redo Dr. Eissenberg's chart, shown in his PDF, and here's what we get:

I've collected study results in chart form over the past two years. Here are three so that e-cig users can make comparisons to other alternative sources of nicotine:

and

and

This rather nicely illustrates that nasal snuff is absorbed almost as rapidly as inhaled smoke, that snus and anything absorbed through the mouth takes much longer to get into the bloodstream but stays a lot longer, that vapor can be effective but doesn't replicate cigarette smoking.

The solution: More than one nicotine alternative, used concurrently, will work to maintain steady state nicotine levels throughout the day.

 

[hifistud]

Hifi, it does make me wonder how the MHRA is going to say that the E-Cigs is classed as 'medical' when it has no affect on metabolism.

The MHRA, being a government QUANGO, will seek to dismiss the study as being flawed, irrelevant, undertaken outside the MHRA's jurisdiction or not representative of the totality of e-cig products - pick whichever one happens to fit best on the day they decide.

But, if they uphold it, they will, simply, rule that, because this study moves towards proving that no nicotine is necessary in an e-cig's nature in order for it to be a stop-smoking device, and, because, therefore, it's a stop-smoking device, it still falls under their purview, and therefore still needs regulating.

Bottom line? They've got their teeth in and they're not going to let go because of a study involving 2 subject materials and 32 participants.

 

[hifistud]

OT here for a lot of reasons. First I'd like to mention that I really liked your youtube video.

Thank you for that.

Second, assuming there is no weight bias to the coin, the chances of the 17th coin flip coming up heads after the last 16 were heads is exactly 50%.

Quite - and while it's not impossible to get 16 straight heads, the probability of it actually occurring is 1 in 65536 - improbable enough to make you check the coin for bias.

Finally, I believe the NFC won the last dozen or so coin flips in the Super Bowl, but next year they have a fifty percent chance of doing it again.

I'm British. I suspect there's a joke in there somewhere, but it's lost on me... ;-)

 

[Belletrist]

Rothenbj recommends nicalert. I was not, to mky knowledge, involved in any "approval" process, but I did do a study on it (Acosta et al., 2004) and we still use it in the lab on a daily basis to verify smoking status. They are tricky to read but work as claimed. Although they react to cotinine they also cross-react with 3 hyrdoxy cotinine which has a much longer half-life. If you smoked a cigarette or used snus five days ago and only vaped since then, a positive result is influenced by the previous tobacco use. They are also sensitive to second hand smoke. In other words, for the purposes you describe, stay away from all non-vaping sources of nicotine for at least 5 days and do not hang out around smokers.

dr. eissenberg, i really appreciate that information. i'm going to do a couple of personal tests over the next 6 weeks, using nicalert, and blog the results; i've invited vaping (non-smoking) readers to do the same. while obviously a personal test using nicalert isn't a rigorous study, i want to eliminate as many variables as i can, so i truly appreciate your input. while i no longer smoke, my husband does on occasion, so i will start avoiding second hand smoke now, so that it will be a week or more without passive exposure.

if you think of any other variables that might influence an at home test, and would be kind enough to pass that information on to me, i'd really appreciate it. and yes... i do expect that my results will show that i'm absorbing nicotine, but if they don't, i will gladly post them anyway. i'd be delighted to find i've kicked my nicotine addiction without knowing it!

 

[Belletrist]

oh, and rothenbj--i appreciate your schlepping over to my blog to contribute to helping me choose which test to use!

 

[DeeEss]

Actually he's defended his statement as quoted ...ECF members have attempted to make the point that the statement is too general and should have specifically referenced only the 2 pv models/companies that were used in the study.

That said, he has been very gracious in coming and participating in the discussion, and while I might disagree with the quoted statements and have questions regarding the methodology of the study, I appreciate his input, support his desire to perform further testing, and thank him for his time and efforts!

Jan

I'm not trying to be pejorative towards Dr. Eissenberg and I looked back and found the post where he said he was not misquoted. If he was offended, I apologize.

I have seen the posts where ECF members disagree with statements as well as methodology and admit that I am one of them. I'm happy that he wants to continue studies as most of us know that e-cigs do deliver nicotine.

 

[teissenb]

My point about the coin was perhaps too glib. What I meant was, if I saw a coin come up heads 16 times in a row, I would cease to believe it was a fair coin [i.e., p(head) = 0.50] and instead assume it was biased toward heads, and thus bet on heads for the 17th toss.

So, generally what I meant was, when you see a result 16 of 16 times you stop thinking that chance is at work and realize what you have is an actual effect.

Actually, Tom Stoppard uses this idea to great effect in the opening of Rosencrantz and Guildenstern are Dead, and the BBC version is wonderfully done. I have used the video when I teach statistics.

 

[curiousJan]

What I meant was, if I saw a coin come up heads 16 times in a row, I would cease to believe it was a fair coin [i.e., p(head) = 0.50] and instead assume it was biased toward heads, and thus bet on heads for the 17th toss.

So, generally what I meant was, when you see a result 16 of 16 times you stop thinking that chance is at work and realize what you have is an actual effect.

Actual effect or serious flaw in the methodology used in the flip thus producing repeatable but inaccurate results.

For the specific instance of the study, these 'flaws' in methodology could potentially be attributable to inattention to the use of the product (not purging the primer fluid from the atty), to measuring only a single indicator of nicotine in the body (rather than including continine and/or other levels in addition to plasma nicotine levels), to inexperience of the user (which was intentionally addressed based upon your comments), or to a handful of other potential factors.

Jan

 

[slybootz]

Test just performed:

[...]
Conclusion:

Bromothymol blue indicator, which is extremely sensitive to pH change, does not respond to the atomizer fluid used in this test, therefore the priming fluid does not contain nicotine.

---

This simple test, of course, can be repeated with other atomizer models, including those used in Dr E's study.

If the priming fluid in the NJoy and Crown 7 atomizers is similarly non-nicotine bearing, and if Dr. E's staff did not purge the priming fluid before giving the ecigarettes to the subjects, Dr. E's study has successfully demonstrated that priming fluid does not contain nicotine (with the realization that a slow mixing of priming fluid and cartridge liquid will begin to occur once the cartridge is attached to the atomizer).

Dr. E, you need to investigate this possibility, as it represents a potentially fatal flaw in your study. If the atomizer priming fluid was not characterized/accounted for, you've got a big problem on your hands.

If you find that your staff, on the other hand, blew out or washed out the priming fluid such that the vapor producing liquid was the nicotine containing cartridge liquid, not the priming liquid, then fatal flaw averted.

very nice tests dvap.

I'd like to make the point to mention that, in many PVs I have purchased, every one of them has mentioned primer fluid in the instruction manuals. When someone purchases a stock e-cigarette, they are expected to have to encounter primer fluid on the atomizer, this is how [all] atomizers are shipped. For the study to not address primer fluid at all, seems to be a flaw in the study.

 

[davew]

This is a very interesting thread. In my own personal experience I was able to stop smoking completely without any cravings for analog cigarettes.

Over the last year I tried to quit using Chantix, Patches, and Commit Lozenges. My success with e-cigarettes has been extremely easy and satisfying. When I got my first e-cigarette I did not purchase enough supplies to last me longer than 3 days. I was able to stop smoking for 3 days and once I ran out I had to smoke regular cigarettes until I received more supplies. I noticed that my first analog made me quite lite headed and I smoked less than I had previously smoked which seemed to me like I had lowered my required intake by using the e-cigarette even though I was physically smoking more on the vapor. This lead me to believe that the e-cigarette is not delivering nearly as much nicotine as an analog.

Several weeks later I am smoke free and the thought of smoking an analog curls my stomach.

I appreciate the data provided in this thread and hope that we are able to sort out the logistics shortly. This industry has the potential to become huge financially and as such there will be some bumps along the way.